Servicios de Medicina Interna, Hospital Clínico San Carlos, Instituto de Investigación San Carlos (IdISSC), Universidad Complutense de Madrid, 28040 Madrid, Spain.
Servicio de Cardiología, Hospital Clínico San Carlos, 28040 Madrid, Spain.
Medicina (Kaunas). 2021 Oct 23;57(11):1150. doi: 10.3390/medicina57111150.
The prevalence and incidence of heart failure (HF) have been increasing in recent years as the population ages. These patients show a distinct profile of comorbidity, which makes their care more complex. In recent years, the PROFUND index, a specific tool for estimating the mortality rate at one year in pluripathology patients, has been developed. The aim of this study was to evaluate the prognostic value of the PROFUND index and of in-hospital and 30-day mortality after discharge of patients admitted for acute heart failure (AHF). : A prospective multicenter longitudinal study was performed that included patients admitted with AHF and ≥2 comorbid conditions. Clinical, analytical, and prognostic variables were collected. The PROFUND index was collected in all patients and rates of in-hospital and 30-day mortality after discharge were analyzed. A bivariate analysis was performed with quantitative variables between patients who died and those who survived at the 30-day follow-up. A logistic regression analysis was performed with the variables that obtained statistical significance in the bivariate analysis between deceased and surviving subjects. A total of 128 patients were included. Mean age was 80.5 +/- 9.98 years, and women represented 51.6%. The mean PROFUND index was 5.26 +/- 4.5. The mortality rate was 8.6% in-hospital and 20.3% at 30 days. Preserved left ventricular ejection fraction was found in 60.9%. In the sample studied, there were patients with a PROFUND score < 7 predominated (89 patients (70%) versus 39 patients (31%) with a PROFUND score ≥ 7). Thirteen patients (15%) with a PROFUND score < 7 died versus the 13 (33%) with a PROFUND score ≥ 7, = 0.03. Twelve patients (15%) with a PROFUND score < 7 required readmission versus 12 patients (35%) with a PROFUND score ≥ 7, = 0.02. The ROC curve of the PROFUND index for in-hospital mortality and 30-day follow-up in patients with AHF showed AUC 0.63, CI: 95% (0.508-0.764), <0.033. The PROFUND index is a clinical tool that may be useful for predicting short-term mortality in elderly patients with AHF. Further studies with larger simple sizes are required to validate these results.
近年来，随着人口老龄化，心力衰竭（HF）的患病率和发病率一直在上升。这些患者表现出明显的合并症特征，这使得他们的治疗更加复杂。近年来，已经开发出一种特定的工具，即 PROFUND 指数，用于估计多种疾病患者的一年死亡率。本研究旨在评估 PROFUND 指数以及急性心力衰竭（AHF）患者住院和出院后 30 天死亡率的预后价值。
进行了一项前瞻性多中心纵向研究，该研究纳入了因 AHF 住院且≥2 种合并症的患者。收集了临床、分析和预后变量。所有患者均采集 PROFUND 指数，并分析住院期间和出院后 30 天的死亡率。对 30 天随访时死亡和存活患者的定量变量进行了双变量分析。对死亡和存活受试者之间双变量分析中具有统计学意义的变量进行了逻辑回归分析。
共纳入 128 例患者。平均年龄为 80.5±9.98 岁，女性占 51.6%。平均 PROFUND 指数为 5.26±4.5。住院期间死亡率为 8.6%，出院后 30 天死亡率为 20.3%。左心室射血分数正常者占 60.9%。在研究样本中，PROFUND 评分<7 的患者居多（89 例（70%）与 PROFUND 评分≥7 的 39 例（31%））。PROFUND 评分<7 的 13 例（15%）患者死亡，而 PROFUND 评分≥7 的 13 例（33%）患者死亡， =0.03。PROFUND 评分<7 的 12 例（15%）患者需要再次入院，而 PROFUND 评分≥7 的 12 例（35%）患者需要再次入院， =0.02。PROFUND 指数对 AHF 患者住院死亡率和 30 天随访的 ROC 曲线显示 AUC 为 0.63，CI：95%（0.508-0.764）， <0.033。
PROFUND 指数是一种临床工具，可用于预测老年 AHF 患者的短期死亡率。需要进一步进行更大样本量的研究来验证这些结果。
